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Mariano Marcos State University

COLLEGE OF HEALTH SCIENCES


Department of Nursing

RLE 105:
Nurse-Patient Interaction
Submitted by:
Angelico L. Garaza
BSNIII-A, Group 3

Submitted to:
Ms. Myrel F. Garvida
Clinical Instructor

March, 2014

NAME: Joseph Jojo Alonzo


BIRTHDAY: December 2, 1962
AGE: 51 years old
GENDER: Male
ADDRESS: Brgy. 9, #256 Aglipay St., Cor Morales St
CHIEF COMPLAINT: Sleeping, talking incessantly and making noise all day and night.
DIAGNOSIS: Bipolar disorder, Manic with psychotic features, Alcohol and Drug abuse; Hypertriglyceridemia and Essential
Hypertension
DATE OF ADMISSION: June 21, 2012
ADMITTING PHYSICIAN: Dr. Medina
OVERVIEW:
Joseph Badula Alonzo is 51 years old and he was admitted at Medina Psychiatric Care Plus and Home Care last July 21, 2012
with a chief complaint of sleeping, talking incessantly and making noise all day and night and had an admitting diagnosis of Bipolar
Disorder Manic with Psychotic Feature, Alcohol and Drug Abuse; Hypertriglyceridemia and Essential Hypertension.
Before he was admitted, he already had a long history of treatment due to Myocardial Infarction and drug abuse. His family
locked him in a room outside their house due to continuous use of drugs, being destructive, and non-compliant to treatment. Based on
the chart, Mr. Alonzo had also been admitted to National Center for Mental Health seven times because of substance abuse. Upon
admission, his mental status examination revealed the patient to be hyperverbal, hyperactive, aggressive, assaultive, poor insight and
judgment, sexually preoccupied disorder with dependent personality.

Before my actual interaction with Mr. Alonzo, I performed measures to prepare myself in rendering care to my patient
emotionally, physically, and intellectually. These include self-awareness activities, reviewing on different communication techniques
both therapeutic and non-therapeutic, reading some books and articles related to possible cases that we will be encountering during
our exposure. After assuring that I and my group mates are completely prepared for our nurse-patient interaction, our clinical
instructor and two staff nurses oriented us about the possible patients, rules and brief background about the psychiatric ward. The
staff nurse assigned and gave us the charts of our patients and I got paired up with Ana Denise Quinajon, my group mate, in
handling a patient named Joseph Alonzo. After reviewing the chart of the patient, I have come to know the brief description and
background of the patient. I feel nervous as soon as the staff nurse warned us that our patient is a difficult one to handle.
NURSE
PATIENT
ANALYSIS
VERBAL
NON-VERBAL
VERBAL
NON-VERBAL
Good morning sir. Are Standing in front the Yes, good morning too Looking directly with a (Giving recognition)
you Mr. Joseph Alonzo?

client; looking directly sir.

faint smile

As soon I saw the client,

at client.

he sat and gave a faint


smile. I feel nervous
because I dont know
how

to

start

the

conversation.

But

gathered

all

of

my

courage.

hope

he

doesnt notice that I feel


I am Angelico Garaza Smiling;

so nervous.
maintaining Nice to meet you sir and Nods while introducing (Giving information)

sir. I am paired up with eye contact with client; maam. I am Joseph ourselves;
Ana Denise Quinajon. sat in front of the client

Alonzo.

trembling

looks
hands

at I

established

our

and contract as soon as we

We are student nurses

hides it under the table; sat in front. I noticed

from Mariano Marcos

bites his lips

State

University.

that as soon as we sat,

We

he hid his hands under

will stay here at Medina

the table between us.

until 12 oclock in the

Maybe he feels shy or

afternoon.
nervous too like we do.
I noticed that you bit Maintaining eye contact My hands cannot stop Shows hands and hides (Making Observations)
your lip sir, do you feel with client.

trembling. I hope you it right away; faintly As soon as I noticed that

uncomfortable?

dont mind sir.

smiles

he is a bit tensed I asked


him directly and I am
relieved that he opened
up with his concern. I
am not a bit bothered
with his hands. I know
that it is an effect of his
medications. I hope he
wont

feel

any

uncomfortable as we go
How long have you Lean forward to the Ive been here since Looks down; frowns

on with our interaction.


(Exploring)

been here sir?

client;

smiling; 2012. So its been more

maintaining eye contact. than a year. Sometimes I


think

that

life

isnt

heard

from

the

orientation that he is one


of the clients that have

You sound very down With

open

worth living and that

stayed here for a long

my family would be

time.

better off without me.


posture; Ive been here too long. Looks up after finishing (Making observations)

today. I can feel a sense maintaining eye contact; I feel like my family his

sentence; I was trying to express

of hopelessness. Am I low voice

really sent me here to unconsciously

puts empathy and mirror his

right about that?

get rid of me.

and sense of sadness. Its

hands

on

table

continues to tremble.

sad to here from the


client that he feels like
he

was

sent

away

purposely where in fact


they just wanted him to
Are these feelings that Nods;

with

get better.
open No actually I have Seemed brighter as he (Encouraging

youve had in the past posture.

always felt pretty good was talking; maintained comparison)

or are they newa

about myself. I have eye contact

I didnt feel like I could

reaction

is

been a good person and

reassure him so I tried

going on in your life

father and thought that I

to learn more about him.

now?

had

to

what

So lets put things in Open


same

person.

to

contribute.
posture; No, Ive not had the Frowns; looks at hands.

perspective. Youre still maintaining eye contact


that

something

courage to do it.

(Exploring)
I thought he should
explore what was going

Maybe

something

is

onto

confirm

or

going on with your

discount

relationship with your

perceptions. I thought I

brother or family. Have

could help him with

you talked with him

this.

about what you


feeling right now?
(Silence)

his

are
Nods;

open

posture; I really am fine now. Frowns; still looking at (Silence)

maintaining eye contact; Why dont they get me? hands.

I remained silent to give

leaning forward

Ive been here for too

room for the client to

long.

verbalize his feelings


more. It gives him time
to organize his feelings.
Im starting to feel sorry

Yes, I understand that Nods; maintaining eye (Silence)

Nods; frowns

for him.
(Accepting)

you really want to go contact; leaning forward

I felt the need to convey

home now sir.

my empathy. He just
nodded and remained

Since when did you Maintaining

eye December.

When

silent.
I Maintains eye contact; (Exploring)

have a call from your contact; leaning forward

called for them that I am plays with hands

Any problem or concern

brother sir?

good to go home.

can be better understood

So

what

are

you Maintaining

planning to do about it contact;


then sir?

eye Im planning to call Maintains eye contact


leaning them

forward; open posture

again

soon.

if explored in depth.
(Formulating a plan of
action)

Explain to them that I

I need to know what his

can really change my

plans

ways. Im better now.

problem.

are
I

for

his

hope

he

could really call his


brother soon and I hope
that he can know why
they havent got him out
We are about to begin Smiles; maintaining eye Yes, I will maam.

of here.
Maintains eye contact; (Giving information and

the activities we have contact; stands up

exchanged

prepared for you today

stands up and joins the Our

sir. I hope you will join.

group

smile; ending the interaction)


interaction

has

ended because its time


for our psychotherapy.
Im relieved that he was
able

to

convey

his

feelings regarding his


eagerness to go home.

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